The Care Quality Commission
  • Doctor
  • Independent doctor

Archived: French Medical Clinic

14 Harley House, Brunswick Place, London, NW1 4PN

Provided and run by:
21st Century Clinic Ltd

All Inspections

10 April 2018

During a routine inspection

We carried out an announced comprehensive inspection on 10 April 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Care Quality Commission previously inspected French Medical Clinic on 22 July 2013, 19 August 2014, 27 February 2015 and 13 June 2017, under our previous methodology. Following these inspections, reports were issued identifying failures to comply with regulations current at the time of inspection.

Seventeen patients provided feedback about the service. All the comments we received were positive about the service, for example describing the doctors as caring.

Our key findings were:

  • The GP could not demonstrate they were delivering effective care and treatment based on evidence based guidelines.
  • All staff had not undertaken safeguarding training to appropriate levels, including the safeguarding lead for the service.
  • Staff carrying out the role of chaperone had not been trained to do this effectively.
  • The provider did not have effective systems in place to record, monitor and analyse significant events.
  • Equipment in the premises had not been serviced or checked by a person experienced to do so, to ensure it was suitable for the purpose for which it was being used.
  • The practice did not have any protocols for prescribing and repeat prescribing and there was no system in place to link prescriptions issued to patients with their care records.
  • The service did not have any systems in place for knowing about and taking action on notifiable safety incidents.
  • The service did not have a quality improvement programme in place to monitor the quality of care and treatment.
  • Staff who carried out the ultra sound scanning and gynaecological examinations did not have the qualifications, training, skills and experience to do so safely.
  • There was no system in place for following up referrals or pathology results.
  • CQC comment cards indicated patients were treated with compassion, dignity and respect.
  • Fees were clearly set out and cost saving initiatives available.
  • The practice did not have a business continuity plan.
  • Staff did not receive formal appraisals or development reviews and were not supported to perform their duties competently through identifying required training.
  • The provider did not maintain accurate, complete and contemporaneous records in respect of each patient.
  • Information about how to complain was available. The provider had not received any complaints about the service in the last year.

We identified regulations that were not being met and the provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Ensure persons providing care and treatment have the qualifications, competence, skills and experience to do so safely.
  • Ensure equipment used for the care and treatment of service users is properly maintained, serviced and calibrated.
  • Establish and operate effective systems or processes to assess, monitor and improve the quality and safety of service users.

Such were the failures to meet regulations we have taken action in line with our enforcement procedures to urgently vary the conditions of the providers registration preventing them from operating the service at this location. The provider has not appealed this decision.

13 June 2017

During a routine inspection

We carried out an announced comprehensive inspection on 13 June 2017 to ask the service the following key questions: Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the Enforcement section at the end of this report).

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the Enforcement section at the end of this report).

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the Enforcement section at the end of this report).

Background

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to follow up on previous breaches of regulation.

The Care Quality Commission previously inspected French Medical Clinic on 22 July 2013, 19 August 2014 and 27 February 2015. Following these inspections, reports were issued identifying failures to comply with Regulations current at the time of inspection.

At the July 2013 inspection we issued compliance actions as there was no equipment or medicines available to respond to medical emergencies. We carried out a follow up inspection in August 2014 and found there was continuing non-compliance in the areas identified, including out of date emergency medicines and expired medical emergencies training. We issued further compliance actions and in February 2015 we found continuing non-compliance in the areas identified, including no medical emergencies training for non-clinical staff. We issued requirement notices under the new Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for breaches of Regulation 12 Safe care and treatment. We checked these areas as part of the June 2017 comprehensive inspection and found arrangements had not been improved.

French Medical Clinic provides private general medical services from the lower ground floor of converted residential premises at 14 Harley House, Brunswick Place, London NW1 4PN. There are three consultation and treatment rooms, administrative offices, staff facilities, a reception and waiting area and patient facilities.

Services are available to any fee paying patient; however the service is predominantly aimed at French speaking patients from Britain and overseas. The service has a high number of patients from French speaking African nations, including Somalia, and British patients from Somali communities across England.

The service is operated by one full time male Professor, two part time female doctors and one male regular Locum doctor. All four clinicians were registered with the General Medical Council (GMC) with a licence to practise at the time of inspection. None of the doctors were on the General Medical Council (GMC) specialist register of clinicians licenced to provide specialist services. The medical team is supported by three part time administrative staff. The service operates Monday to Friday with pre booked appointments available between 10am and 5pm. Appointments and home visits can also be arranged to be conducted outside of these times by prior arrangement.

Professor Boyde is the registered manager of the service. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. We received 27 comment cards which were all positive about the standard of care received. Comments included that all staff, including doctors, were kind, caring and treated patients with respect. We also spoke with two patients during the inspection who both said they were satisfied with the care they received and told us that appointments were convenient, that doctors gave them enough time during their consultation and that they were involved in their care and treatment.

Our key findings were:

  • The provider did not assess the risks to health and safety of service users and do all that was practicable to mitigate such risks.
  • The provider did not have adequate arrangements in place for responding to medical emergencies; there was no Automatic external defibrillator (AED), emergency equipment including pulse oximeters and blood glucose meters were not working, emergency medicines including Benzylpenicillin and Chlorphenamine were not available and the Oxygen cylinder had expired and was empty.
  • Persons providing care and treatment did not have the qualifications, competence, skills and experience to do so safely with regards to ultra sound scanning, gynaecological examinations and fertility treatments.
  • The provider did not ensure the premises were safe to use for their intended purpose by having an up to date fire risk assessment carried out.
  • The provider did not assess the risk of, prevent, detect and control the spread of infections including those that are healthcare associated.
  • Equipment used by the provider for the care and treatment of service users was not properly maintained, serviced or calibrated.
  • There was no evidence the provider was assessing, monitoring and improving the quality of care provided to service users.
  • We did not see evidence of an induction programme in place or records of inductions provided to staff and the provider did not identify on-going training for staff.
  • The provider did not have a system of appraisal and personal development in place to ensure the learning and development needs of non-clinical staff were identified and met.
  • Patients told us they felt involved in decision making about the care and treatment they received. They also told us they felt listened to and supported by staff and had sufficient time during consultations to make an informed decision about the choice of treatment available to them.
  • There was information in the reception area and on the service website which detailed the arrangements for dealing with complaints, the arrangements for respecting dignity and privacy of patients and the services available.
  • The service offered appointments primarily to French speaking patients; however the service was open to any fee paying patient, with fees clearly set out and cost saving initiatives available.
  • The service did not have an effective overarching governance framework supporting the delivery of good quality care.

We identified regulations that were not being met and the provider must:

  • Ensure the risks to health and safety of service users are identified and assessed and do all that is practicable to mitigate such risks.
  • Ensure persons providing care and treatment have the qualifications, competence, skills and experience to do so safely.
  • Assess the risk of, prevent, detect and control the spread of infections including those that are healthcare associated.
  • Ensure equipment used for the care and treatment of service users is properly maintained, serviced and calibrated.
  • Establish and operate effective systems or processes to assess, monitor and improve the quality and safety of service users.

You can see full details of the regulations not being met at the end of this report.

27th February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Dear Provider

During our last inspection on 19 August 2014 we found that you did not have adequate arrangements in place to deal with foreseeable emergencies.

We did not see evidence that staff were trained to deal with medical emergencies and in basic life support. We also found one of the emergency medicines was out of date.

At this inspection we found adequate arrangements were still not in place to deal with foreseeable emergencies. The emergency drugs we checked were within expiry date however, non-clinical staff had not received recent training in basic life support or dealing with medical emergencies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

19 August 2014

During an inspection looking at part of the service

During our last inspection on 22 July 2013 we found that the provider did not have adequate arrangements in place to deal with foreseeable emergencies. The practice did not have equipment or emergency medicines available for use in the event of a medical emergency.

At this inspection we found that the provider had taken some action to deal with foreseeable emergencies, however there were still shortfalls. Although equipment was available for use in the event of a medical emergency, we did not see evidence that staff were trained to deal with medical emergencies and in basic life support. We also found one of the emergency medicines was out of date.

22 July 2013

During a routine inspection

We spoke with three people using the service and have also used the feedback and comments from the provider's most recent satisfaction survey. People rated the care and treatment highly and their comments included "the doctor is really nice and friendly" and " I'm really satisfied by him and his staff".

People's needs were assessed and care and treatment was planned and delivered in line with their individual wishes. Consultations were held in private consulting rooms and the findings were recorded at the time in people's medical records.

There were some arrangements in place to deal with foreseeable emergencies. Although staff were trained to deal with medical emergencies and in basic life support there was no equipment or emergency drugs available for immediate use.

Professional staff working in the clinic received an annual appraisal and attended training to update their knowledge and skills. There were systems in place to monitor and improve the quality of service provided.